Latest / Becker’s Healthcare Podcast / Evaluating Healthcare Technology Investments and Outpatient Innovation with Meredith Warf

Transcript

Evaluating Healthcare Technology Investments and Outpatient Innovation with Meredith Warf · Becker’s Healthcare Podcast

• 0:00
  - Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm
• 0:02
  - Scott King, thrilled today to be joined by
• 0:04
  - a very special guest, Meredith Worth, former chief
• 0:06
  - executive officer. Meredith, how are you? Thanks so
• 0:08
  - much for making time for us. Oh, thanks
• 0:10
  - for having me, Scott. Appreciate it. Yeah. No.
• 0:13
  - We have a lot of big topics, in
• 0:15
  - health care to get to. But before we
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  - do that, I was wondering if you could
• 0:17
  - just kinda touch on are there specific
• 0:20
  - procedure types where
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  - next gen tech clearly outperforms
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  - conventional approaches versus
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  - others where the data is still too thin
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  - to justify the premium?
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  - You know, everything seems to be talking about
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  - the
• 0:35
  - extremely
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  - fast progression of technology in all areas of
• 0:39
  - health care, whether it's in
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  - AI, IT,
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  - procedural technology.
• 0:45
  - Things just get bigger and better at an
• 0:47
  - exponential rate, it seems, every day. I really
• 0:50
  - would rely on surgeons for those technological benefits.
• 0:54
  - They are the true experts in their craft
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  - and what they do, and they've
• 0:57
  - done it really well with robotics and for
• 1:00
  - years and years and years, decades,
• 1:02
  - without them. So the procedural
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  - benefits are
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  - maybe a little more vague to speak on.
• 1:09
  - I think there there are I know there
• 1:11
  - are standardization
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  - benefits
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  - with the basic steps of certain procedures, especially
• 1:17
  - in,
• 1:18
  - an outpatient setting where efficiency
• 1:21
  - and, you know, patient satisfaction are
• 1:24
  - all the name of the game.
• 1:27
  - Standardization is how you can assure
• 1:29
  - the most consistent,
• 1:30
  - experience and outcomes,
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  - and
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  - it also allows for customization
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  - where it really matters.
• 1:37
  - So, you you know, there's no surgery that's
• 1:39
  - exactly like another one. So if you've got
• 1:41
  - the basic steps and processes
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  - standardized, then the the surgeon, who really is
• 1:46
  - the artist, is able to customize
• 1:48
  - to the patient what what they need.
• 1:51
  - You know, technology really may improve marketing appeal.
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  - That's no no secret in workflow,
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  - but outcomes typically don't change
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  - as much. So the million dollar question is
• 2:02
  - really, how do we justify the added cost
• 2:05
  - of these advancements?
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  - The other aspect I like to think about
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  - is, you know, many academic medical centers are
• 2:12
  - really training on this new technology.
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  - They have access to this sometimes first before
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  - other smaller practices
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  - and,
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  - areas are have availability.
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  - So the new surgeons that are going to
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  - work in these in these places
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  - may be more
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  - accustomed to using this technology. So we have
• 2:31
  - to think about
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  - you know, the price is what we have
• 2:34
  - to think about to make sure that we
• 2:36
  - address
• 2:37
  - these accessibility issues to continue growth.
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  - You know, the the main question on
• 2:43
  - this topic I like to think about is,
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  - does the technology really change the outcome,
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  - or does it just change how we get
• 2:50
  - to the same outcome?
• 2:52
  - So that's a a poignant
• 2:54
  - note to think about before we go and,
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  - you know, all in on certain new technologies.
• 3:00
  - No. Absolutely. You know, I really like your
• 3:02
  - reminder in there too that
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  - every surgery
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  - is different. You you know, I think people
• 3:07
  - forget that they hear all the the surgery
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  - is happening that usually goes like this. But
• 3:11
  - and
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  - I think that's because
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  - Mary, do you think that there are a
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  - big reason for that is that every patient
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  - is different and maybe that's why every surgery
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  - is different. Absolutely.
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  - You know, we see there's a saying in
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  - the in the industry that when you have,
• 3:26
  - just like patients, when you've met one ASC,
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  - you've or seen one ASC, you've only seen
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  - one ASC. You know, it's the same thing.
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  - So patients all have different
• 3:36
  - personal goals and different injuries and, you know,
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  - the process,
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  - you know, what what they're having done in
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  - surgery is the billing code might be the
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  - same, but everyone will vary just a little
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  - bit.
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  - No. Certainly not a one one size fits
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  - all approach.
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  - In the ASC setting, how should surgeons and
• 3:53
  - administrators
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  - build the financial model for a major
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  - surgical technology buy?
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  - You know, this is a great question. And
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  - being approached by
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  - many vendors
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  - with this latest technology,
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  - there are some questions you really have to
• 4:10
  - think about.
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  - It depends on how the surgery center is
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  - owned. How is it managed? How is the
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  - accounting
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  - reported?
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  - What is your core valuation metric? Right? Do
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  - you want to purchase
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  - is it better to purchase this equipment outright,
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  - or should you lease to own it? As
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  - a caveat, I always like to think twice
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  - about owning technology that transforms so quickly.
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  - You know, you need to replace it a
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  - few years in if if you actually buy
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  - it outright on day one with certain things.
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  - So
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  - think about, you know, what are the ramifications
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  - of categorizing this as a capital lease versus
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  - a fair market value lease.
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  - And sometimes you might rather add back that
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  - interest expense than pay a surcharge on your
• 4:52
  - implants for the next five years. So vendors
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  - have hundreds of ways that they can put
• 4:56
  - these, you know, packages together. And
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  - most often, it's done in a placement,
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  - you know, usage threshold with, rebates,
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  - which is great. But I would always advise
• 5:08
  - to dig a little bit deeper and see
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  - which one really fits
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  - the ASC and the the problem you're trying
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  - to solve the best. So do we really
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  - need help with cash flow today, or would
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  - we rather
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  - think about that a different way?
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  - We're seeing robotics and AI navigation touted everywhere.
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  - What's the honest threshold the practice should hit
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  - in case volume before the capital investment
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  - genuinely
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  - pays off?
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  - Great question. So volume is obviously one of
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  - the obvious, you know, metrics that you've got
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  - to have a a threshold on, but it's
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  - certainly not the only threshold.
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  - I've seen organizations
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  - invest in technology
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  - based on one surgeon champion, and you know
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  - what? They struggle.
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  - The winners in these situations usually have at
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  - least
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  - three to five surgeons or committed users of
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  - the new technology, whether it's a robot or,
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  - instruments or what whatever that may be before
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  - signing that purchase agreement. And, you know, we
• 6:08
  - can look at financial models to see whether
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  - that magic number is 250
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  - or 350
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  - cases a year. That's just math, and we
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  - can plug that in and do a sensitivity
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  - analysis.
• 6:19
  - In reality, it's really still breakeven. So you
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  - have to factor in
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  - other aspects of extra cost of disposables,
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  - added sterilization
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  - cost of, you know, additional equipment, service contracts,
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  - which can be very expensive,
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  - software programs, training. And then what is more,
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  - you know, in the slim margin ASC space,
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  - really partnering with one vendor for certain procedures
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  - like arthroplasty
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  - or
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  - spine or or traumas types of surgeries
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  - or
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  - eyes or it doesn't matter what single specialty
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  - that you're talking about. And by partnering, I
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  - really mean a bidirectional commitment for more than
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  - just products.
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  - I like to say that in the successful
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  - ASC,
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  - all the employees are what we call utility
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  - players.
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  - Everybody can do more than just one job.
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  - And this really broadens to your reps that
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  - are in your facility
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  - every day as well. So everyone has to
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  - work together in the success of that efficiency
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  - that you're striving for, whether it's turning over
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  - instruments, moving equipment, pitching in to help, and
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  - and whatever that's needed.
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  - At the end of the day, there is
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  - a great opportunity cost of not
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  - being aligned in the technology
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  - to solve a problem. You don't want, you
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  - know, four
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  - different types of
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  - ways to do a certain thing that you
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  - use technology for. Does that make sense? Yeah.
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  - No. Of course.
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  - And to kind of reduce to our next
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  - question, how are you thinking about data when
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  - evaluating all these
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  - new innovations in spine?
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  - As more and more procedures
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  - move into the outpatient space, you know, now
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  - they're doing
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  - single and multilevel
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  - lumbar fusions,
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  - and not a whole patient's are same, again,
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  - like we talked about. And just like the
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  - migration of total joints, spine procedures,
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  - they've been done well in the outpatient space
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  - for years. They're just becoming more complicated.
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  - So
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  - they really move the needle on how to
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  - solve the or how to really lower the
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  - cost of care.
• 8:19
  - Just like we have to think about efficiency,
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  - we've got to think about the complication risk
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  - for the individual patient.
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  - And, you know, physicians are experts at at
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  - doing this, and the surgeons know who's a
• 8:29
  - good candidate and who's not. It's more than
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  - just a diagnosis code on a page. Unfortunately,
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  - insurance companies are very
• 8:37
  - sometimes they don't understand that. But being able
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  - to pull the data from the vast datasets
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  - to help personalize that road map
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  - and identify the individuals who are best candidates
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  - for an outpatient surgery
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  - is really where I see the biggest benefit
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  - of
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  - the
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  - data and these, you know, machine learning and
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  - putting this data together to help us really
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  - understand
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  - that complication risk. And if we can do
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  - that in a systematic way that
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  - payers understand,
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  - potentially,
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  - it could help us in this
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  - delineation between
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  - one patient that needs
• 9:16
  - a spine procedure versus another patient that needs
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  - a spine procedure
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  - with the same diagnosis but has incredibly different
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  - complication risk.
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  - Yeah. I think that makes a lot of
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  - sense as well, Meredith. And the last question
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  - I have for you, which innovations
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  - in spine and orthopedic care will have the
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  - most meaningful impact
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  - on how care is delivered in the next
• 9:38
  - two to three years?
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  - So
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  - we really have to answer
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  - a question here. It it what problem are
• 9:45
  - we trying to solve? This is coming at
• 9:47
  - us from all different directions.
• 9:50
  - It all sounds great. It's all very expensive.
• 9:54
  - You know, it's like we look back to
• 9:56
  - the digital revolution time in the nineties and
• 9:58
  - early two thousands where if a company put
• 10:01
  - .com in their name, they're automatically
• 10:03
  - a
• 10:04
  - digital company.
• 10:06
  - And AI is the same way.
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  - In these days, it's almost
• 10:10
  - could be considered a buzzword that everybody uses.
• 10:13
  - It's very important that we ask
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  - what problem are we trying to solve, and
• 10:18
  - then is this truly solving it, or is
• 10:21
  - it just another way to get to the
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  - same
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  - result that it has a hefty price tag?
• 10:26
  - So the question is, which innovations will have
• 10:29
  - the the most meaningful impact in how care
• 10:32
  - is delivered?
• 10:33
  - I would go with a few starting with
• 10:36
  - clinical documentation.
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  - The burden
• 10:39
  - of
• 10:40
  - clinic
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  - and the time it takes to
• 10:43
  - record everything that's mandated by
• 10:46
  - regulatory
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  - requirements
• 10:49
  - as well as just the EMR systems themselves.
• 10:52
  - Look. If you talk to five surgeons who
• 10:54
  - use five different EMRs,
• 10:56
  - nobody likes their system.
• 10:58
  - We all know that. So
• 10:59
  - having a solution to make it quicker to
• 11:02
  - document what they need to document will help.
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  - And it will help in the, clinic as
• 11:08
  - well with FaceTime with the patient.
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  - The number two, I would say, is a
• 11:12
  - revenue cycle.
• 11:13
  - The bot wars, I like to call it,
• 11:15
  - continue.
• 11:16
  - Insurance companies have used these bots for years,
• 11:19
  - and now practices are using it. So the
• 11:21
  - bots are talking to the the bots. And
• 11:24
  - as you can imagine, they're stalemates, and human
• 11:27
  - intervention is required
• 11:28
  - in a lot of cases. And it really
• 11:31
  - the result is delays in payments, which we
• 11:33
  - know
• 11:34
  - are never,
• 11:36
  - never optimal.
• 11:37
  - Prior authorization,
• 11:39
  - I mentioned a little bit of that earlier,
• 11:41
  - but
• 11:42
  - being able to remove some of the barriers
• 11:45
  - to get a patient to to have the
• 11:48
  - procedure that he or she needs is
• 11:50
  - excellent.
• 11:53
  - The anesthesia models are another that I I
• 11:55
  - believe that we've got some opportunity to use
• 11:58
  - some machine learning to do, whether that's
• 12:01
  - scheduling cases more efficiently.
• 12:04
  - But the anesthesia problem is
• 12:07
  - is not going away. Right? It's only getting
• 12:09
  - bigger. So we've really got to that is
• 12:12
  - a huge problem we need to solve.
• 12:14
  - And then really patient, prediction analytics, like I
• 12:18
  - mentioned earlier, for customized care pathways and pre
• 12:21
  - op and post op preparation for patients, really
• 12:24
  - tailoring
• 12:25
  - each
• 12:26
  - treatment
• 12:27
  - to the specific patient and what they need
• 12:30
  - in their in their goals.
• 12:32
  - One another question I would encourage,
• 12:34
  - you know, those to think on is, you
• 12:36
  - know, five years from now, which technologies
• 12:39
  - are we gonna look back and
• 12:42
  - think on as transformational,
• 12:44
  - and which ones will will we realize we're
• 12:47
  - really just marketing innovators.
• 12:49
  - So, again,
• 12:51
  - solving a problem is the name of the
• 12:53
  - game. It's an exciting time and really sometimes
• 12:56
  - overwhelming to try to follow each and every
• 12:59
  - update.
• 12:59
  - And at the end of the day, does
• 13:02
  - it change the way that we deliver care?
• 13:04
  - No. I I I think we've been delivering
• 13:06
  - care very well for a long time, but
• 13:08
  - are there ways to get more efficient to
• 13:10
  - help patients feel more comfortable
• 13:13
  - taken care of and, again, to reach their
• 13:15
  - goals faster?
• 13:16
  - And then number one, at a lower cost
• 13:19
  - for everybody involved.
• 13:21
  - Yeah. Absolute absolutely, Meredith. I I think it's
• 13:22
  - a great point to just kinda remember how
• 13:24
  - to think about how care should be delivered
• 13:27
  - despite all the emerging tech everyone's kinda weeding
• 13:30
  - through and what's best for their system, but
• 13:31
  - that that should definitely remain the focus. And
• 13:33
  - thank you so much for joining us on
• 13:34
  - podcast. It was great talking to you, and
• 13:36
  - hope to work with you again soon. Thank
• 13:38
  - you so much, Scott.